1. Field of the Invention
The invention relates to the dental surgical devices for elevating the Schneiderian membrane, and more particularly, to the dental devices for bone augmentation for dental implant. Specifically, the invention relates to the devices which are designed for the surgical placement of the dental implants in the maxillary jaw bone. Still more specifically, this invention relates to the growing of jaw bone in order to obtain adequate volume of osseous structure for dental implant.
2. Description of Related Art
Due to the destructive nature of dentures to the underlying jaw bone as well as to the fact that bone that is not internally stimulated by tooth roots will atrophy, the amount of bone in many people is very limited for the placement of dental implants. The successful placement of the dental implants is very well known and is based on a variety of factors including: surgical technique, health of the patient, operator skill and, to a significant part, sufficient bone for the placement and integration of the dental implant. The dental implants are generally used in the anterior lower jaw, as this region provides sufficient bone quantity, quality and strength to support and hold the installed dental implant. However, the replacement of the maxillary teeth have presented a considerable challenge because after the loss of maxillary teeth the quality and quantity of the remaining supporting bone may be insufficient to properly and reliably support the dental implant. Also, the success of the dental implants has been limited by the quality and quantity of existing bone a given patient would present with. For example, individual tooth implants have been successfully carried out, and this procedure is now relatively common, but again, this process may not be suitable for many dental patients due to a lack of available bone.
It is known that the maxillary bone structure composed of alveolar bone and basal bone. The maxillary teeth, and more specifically the teeth roots, are located in the alveolar bone. The upper surface of the maxillary structure is the floor of the maxillary sinus and is in contact with a thin Schneiderian membrane (also known as “subantral membrane” or “sinus membrane” [hereinafter may be mentioned as “membrane”]). After tooth is removed from the maxillary bone, the surrounding alveolar bone is frequently resorbed because of the lack of physical stimulation and support of the teeth. This, as it is well known, leads to a loss of bone mass and a corresponding reduction in the effective height and thickness of the bone of the maxillary complex, which if not restored would limit the potential use of the dental implant. In order to overcome the deficiency of insufficient vertical bone mass of the maxillary complex, There are known in the dentistry some surgical techniques to increase the bone mass for the placement of dental implants. These techniques augment the bone deficient region with a regenerative synthetic graft material, which should be placed between the upper surface of the maxillary bone and membrane in such manner that it does not traumatize or even injure the membrane and does not interfere with the function of the maxillary sinus. Thus, the membrane should be carefully lifted to provide some space for the artificial bone draft material without osteogenesis distraction.
If the membrane is not carefully and properly lifted, the bone augmentation process may puncture the thin sinus membrane creating serious medical consequences.
The one of the membrane lifting procedure is known as Dr. R. B. Summers' procedure, providing the approach to the maxillary sinus from the alveolar ridge utilizing solid cylindrical instrument. The instrument vertically mechanically lifts the membrane from the bottom area of the maxillary sinus. The graft material is then placed into the freed space between the elevated membrane and upper surface of the maxillary bone through the aperture in the bone (e.g., trough the socket of the extracted tooth, etc.). The dentist should be very careful and precise moving the instrument through the socket in order not to tear, ripping or perforate the membrane by pushing the instrument in the sinus compartment far away from the line of the upper surface of the maxillary bone, considering the missing feedback.
The one of the known techniques for dental implant installation in the maxillary jaw uses the sleeve inserted through the alveolar ridge to the maxillary sinus. The sleeve is used to raise the Schneiderian membrane and form a cavity. A bone growth stimulant (draft material), is injected through the sleeve into the cavity. In the process, the sleeve also can cut and/or condense the bone around itself so that the bone can hold an implant. Optionally, the bone draft material is also introduced into the bone surrounding the sleeve. During the injection, the pressure within the sleeve or the cavity is monitored to detect and prevent the rupture of the membrane.
Such device(s) are very complex and do not provide sufficient safety for membrane.
The Patent Application Publication No. US2001/0012607 describes a method of growing additional maxillary (or mandibular) bone in areas of atrophy and by the use of a related device to accomplish the task. A pliable guided-tissue regeneration plate, which holds it shape after being bent, is employed as a mating component to a support screw or a dental implant and is secured to the jaw structure by fixation of the guided-tissue regeneration plate at a predetermined distance above or away from the surface of the bone to the support screw or dental implant in order to create a supported and protected space between the underside of the gum tissue and the original bone which is free from muscular and chewing pressure in order to promote bone growth.
The guided-tissue regeneration plate support and fixation system can be mated with a support screw or screws which are tenting screws designed to be mated with and then become intimately a part of the guided-tissue regeneration plate in order to grow bone in the space created by the guided-tissue regeneration plate system prior to implant placement. Additionally, the guided-tissue regeneration plate system can be utilized during implant placement by creating space adjacent to a dehisced implant by fixation of the guided-tissue regeneration plate directly to the implant in order to grow bone height or width. A guided-tissue regeneration plate according to the present invention can also be used by affixing it to an existing dental implant that has been previously placed and has undergone bone loss in order to regenerate new bone. The guided-tissue regeneration plate support and fixation system is adapted to be surgically removed after the bone has grown under its surface at a later uncovering or implant placement surgery. In an alternative preferred embodiment which provides particularly successful results and which results in faster and better bone regeneration and periosteum growth, the guided-tissue regeneration plate consists of first and second integrated components including a first support plate component having a peripheral region and a generally open central portion and a fine mesh screen juxtaposed over the central portion and fixed to the peripheral region thereof. In a functionally equivalent variant of the alternative preferred embodiment, the guided-tissue regeneration plate is fabricated starting with an imperforate plate (for example, of titanium) and then reducing the thickness of predetermined central regions of the plate, a step which can be carried out, for example, by employing a conventional photoresist mask over the plate in conjunction with an acid etch. After the desired thickness of the central regions has been obtained, the central regions may be perforated with finely spaced apertures using, for example, conventional laser machining techniques.
Specifically, the invention uses guided-tissue regeneration plate which has been molded, then bone graft material is packed beneath the plate and against the existing bony ridge. After a period of approximately four-to-eight months, a new bony ridge will form within the space created by the guided-tissue regeneration plate support, its fixation system, and the cortical bone (more precisely, the gum tissue). In order to place a guided-tissue regeneration plate support and fixation system according to the present invention, the tissue is first reflected away from the bony ridge to expose the ridge in its entirety. The palatal gum tissue is reflected, the facial gum tissue is reflected, and a guided-tissue regeneration plate support screw is placed into the bony ridge. Later the guided-tissue regeneration plate support and fixation system has been removed exposing the new bony ridge (a small hole remains after the removal of the guided-tissue regeneration plate support screw) and implant can be placed (installed) into the new bony ridge (a tooth can be attached to the implant later).
Such method may easily traumatize the tissue.
Another known techniques for dental implant installation in the maxillary jaw utilizes a surgical tool used for preparing a surgical sinus-lift. The tool has an instrumental tip to cut, crack and push bone from the sinus floor upward into the sinus. The apical instrumental tip is driven into a pre-drilled pilot after the cutting maxillary bone threads are engaged and rotated until the sinus floor is cracked free. Once the bony sinus floor is cracked free, a fluid passageway can be pressurized with a sterile fluid at a defined pressure to release and push the sinus membrane upward into the sinus cavity to create a desired apical cavity for grafting.
For instance, the devices by U.S. Pat. Nos. 7,771,199 and 8,029,284 use the fluid pressure to release and push the sinus membrane:
a) the U.S. Pat. No. 7,771,199 to Hochman et al. comprises the defined thread geometry in series with an instrumental tip to cut, crack and push bone from the sinus floor upward into the sinus cavity in a tactual, gentle and controlled motion. The apical instrumental tip is driven into a pre-drilled pilot after the cutting threads are engaged and rotated until the sinus floor is cracked free. Once the bony sinus floor is cracked free, a fluid passageway can be pressurized with a sterile fluid at a defined pressure to release and push the sinus membrane upward into the sinus cavity to create a desired apical cavity for grafting while minimizing the risk of compromising or tearing the sinus membrane.
b) the U.S. Pat. No. 8,029,284 to Better et al. includes a dental implant having a proximal implant end and a lateral external surface. The implant is shaped so as to define a lumen therethrough having a lateral opening through the lateral external surface. The apparatus further includes an applicator, which is removably coupled to the proximal implant end. The applicator includes a delivery tube having a distal tube end that is removably coupled to the implant such that the delivery tube is in fluid communication with the lumen via the lateral opening. Other embodiments are also described.
Another device by U.S. Pat. No. 8,029,523 to Willis et al. includes a tubular element, and a cutter spring-biased relative to the tubular element. In an unloaded configuration the cutter is displaced relative to the tubular element by a displacement distance, and when the cutter is in a loaded configuration the displacement distance is reduced. A first structure is longitudinally fixed relative to the cutter and rotationally engaged relative to the tubular element. A length of the first structure extends proximally in the unloaded configuration. A second structure is longitudinally displaceable relative to the first structure. In the loaded configuration, a driver engages and rotates both the first and second structures, and thus the tubular element and cutter together. Once the cutter breaks through the bone, the cutter spring-biased into the unloaded configuration, resulting in disengagement of the first structure from the driver to prevent rotation of either the tubular element or the cutter. When the main cutter has pierced all maxillary bone, the spring causes the auxiliary cutter to lift the membrane.
Some techniques describes an implant comprising at least one shaft area for anchoring in a bony structure, and at least one opening at the distal end of the shaft area in which the shaft area has a continuous bore extending from the opening to at least one outlet at the apical end, so that targeted introduction of material at least into the periapical area is possible with a stable anchoring in the bone structure even after implantation.
The U.S. Pat. No. 7,662,188 to Yamada discloses an internal sinus manipulation procedure and instrument for augmenting bone of a dental patient between the floor of the patient's sinus and a raised portion of the patient's sinus membrane comprising exposing a portion of the patient's sinus membrane immediately adjacent the floor of the patient's sinus followed by a lifting and lateral separation of the exposed portion of the sinus membrane from the sinus floor to form an open pocket between the sinus membrane and the sinus floor.
Specifically, following the formation of the bone aperture (channel), a conventional depth gauge instrument having axially spaced measuring marks and a blunt tip is employed to measure the thickness of the bone in the channel and to verify the amount of the membrane lifting previously determined in the development of the patient treatment plan.
All these devices have a deficiency—they depend only on carefulness of the dentist with respect to the membrane elevation. They do not provide a limitation of the deepness of the passage through the jaw's aperture into sinus compartment, thereby, creating dangerous lifting of the Schneiderian membrane considering possible sudden, unexpectedly stressed movements of the dentist's hands during membrane elevation, etc.
Therefore, the mentioned known methods and devices have the described above deficiencies which are eliminated in the improved surgical device for elevating the Schneiderian membrane.
While the mentioned above prior art fulfill their respective, particular objectives and requirements, the mentioned inventions do not disclose, teach and/or suggest the device for dental implant installation including the elements (components/parts) inflating its/their capacity/volume to securely move the Schneiderian membrane providing internal place for the material drafting the artificial bone(s).
Those skilled in the art will readily observe that numerous modifications and advantages of the improved device for dental implant installation may be made while retaining the teachings of the invention.
Thus, the known prior art do not provide the efficient, satisfied, convenient device for dental implant installation according to the present invention substantially departs from the devices of the prior art.
Accordingly, several objects and advantages of the present invention are to provide the improved surgical device for elevating the Schneiderian membrane:
It is another object of the invention increase the safety of the Schneiderian membrane during dental procedure of elevation the Schneiderian membrane.
It is further object of the invention to minimize the possible traumatization of the Schneiderian membrane during lifting of the Schneiderian membrane.
It is still another object of the invention to increase the convenience and efficiency of the dental device for preparation of the dental implant installation.